Horticultural therapy for homeless people

My ambition with this master's thesis is to provide an analysis of what the key features are in a healing garden for the homeless. This includes but is not limited to: facilities, plant material, work routines, regulations and design considerations. The thesis explores in three parts; (1) the causes and conditions of homelessness in the USA, (2) the needs of the homeless population in the USA, (3) and how we can best address these needs through horticultural therapy. The first part is based on a literature study of research from the disciplines of social science, medicine and psychology to clarify the needs and issues of the United States Homeless Population. I also spent many hours interviewing and working alongside homeless men and women in order to better understand their situation on a more personal level. The second part is a one-case study of the Homeless Garden Project in Santa Cruz, CA. This study is based mainly on interviews that I conducted both with the homeless participants and with the staff of the program. I have also recorded my own observations of the program that I made while on site working and interviewing. By applying a phenomenological model for analysis of the collected interview material I have made a gradually deepened interpretation thereof. In the third part I compile the information gathered in the previous parts and recommend appropriate methods for addressing the needs of homeless people. First the homeless person's needs are discussed with recommendations for approaches to design, regulations, choice of plant material etc. Secondly, aid to common ailments within the homeless population are addressed and discussed. The two different approaches cater to people in different professional fields – builder/planner and medical/social service. Although my research has been focused on the USA there may well be similarities with, and practices that are applicable to, other parts of the world

Daily Step Count and Incident Diabetes in Community-Dwelling 70-Year-Olds: A Prospective Cohort Study

Background: Older adults with diabetes take fewer steps per day than those without diabetes. The purpose of the present study was to investigate the association of daily step count with incident diabetes in community-dwelling 70-year-olds. Methods: This prospective cohort study included N = 3055 community-dwelling 70-year-olds (52% women) who participated in a health examination in Umeå, Sweden during 2012–2017, and who were free from diabetes at baseline. Daily step count was measured for 1 week using Actigraph GT3X+ accelerometers. Cases of diabetes were collected from the Swedish National Patient Register. The dose-response association was evaluated graphically using a flexible parametric model, and hazard ratios (HR) with 95% confidence intervals (CI) were calculated using Cox regressions. Results: During a mean follow-up of 2.6 years, diabetes was diagnosed in 81 participants. There was an inverse nonlinear dose-response association between daily step count and incident diabetes, with a steep decline in risk of diabetes from a higher daily step count until around 6000 steps/day. From there, the risk decreased at a slower rate until it leveled off at around 8000 steps/day. A threshold of 4500 steps/day was found to best distinguish participants with the lowest risk of diabetes, where those taking ≥ 4500 steps/day, had 59% lower risk of diabetes, compared to those taking fewer steps (HR, 0.41, 95% CI, 0.25–0.66). Adjusting for visceral adipose tissue (VAT) attenuated the association (HR, 0.64, 95% CI, 0.38–1.06), which was marginally altered after further adjusting for sedentary time, education and other cardiometabolic risk factors and diseases (HR, 0.58, 95% CI, 0.32–1.05). Conclusions: A higher daily step count is associated with lower risk of incident diabetes in community-dwelling 70-year-olds. The greatest benefits occur at the lower end of the activity range, and much earlier than 10,000 steps/day. With the limitation of being an observational study, these findings suggest that promoting even a modest increase in daily step count may help to reduce the risk of diabetes in older adults. Because VAT appears to partly mediate the association, lifestyle interventions targeting diabetes should apart from promoting physical activity also aim to prevent and reduce central obesity

Replacing monocultures with mixed-species stands: Ecosystem service implications of two production forest alternatives in Sweden

Whereas there is evidence that mixed-species approaches to production forestry in general can provide positive outcomes relative to monocultures, it is less clear to what extent multiple benefits can be derived from specific mixed-species alternatives. To provide such insights requires evaluations of an encompassing suite of ecosystem services, biodiversity, and forest management considerations provided by specific mixtures and monocultures within a region. Here, we conduct such an assessment in Sweden by contrasting even-aged Norway spruce (Picea abies)-dominated stands, with mixed-species stands of spruce and birch (Betula pendula or B. pubescens), or spruce and Scots pine (Pinus sylvestris). By synthesizing the available evidence, we identify positive outcomes from mixtures including increased biodiversity, water quality, esthetic and recreational values, as well as reduced stand vulnerability to pest and pathogen damage. However, some uncertainties and risks were projected to increase, highlighting the importance of conducting comprehensive interdisciplinary evaluations when assessing the pros and cons of mixtures

Residential traffic exposure and pregnancy-related outcomes: a prospective birth cohort study

Background. The effects of ambient air pollution on pregnancy outcomes are under debate. Previous studies have used different air pollution exposure assessment methods. The considerable traffic-related intra-urban spatial variation needs to be considered in exposure assessment. Residential proximity to traffic is a proxy for traffic-related exposures that takes into account within-city contrasts. Methods. We investigated the association between residential proximity to traffic and various birth and pregnancy outcomes in 7,339 pregnant women and their children participating in a population-based cohort study. Residential proximity to traffic was defined as 1) distance-weighted traffic density in a 150 meter radius, and 2) proximity to a major road. We estimated associations of these exposures with birth weight, and with the risks of preterm birth and small size for gestational age at birth. Additionally, we examined associations with pregnancy-induced hypertension, (pre)eclampsia, and gestational diabetes. Results. There was considerable variation in distance-weighted traffic density. Almost fifteen percent of the participants lived within 50 m of a major road. Residential proximity to traffic was not associated with birth and pregnancy outcomes in the main analysis and in various sensitivity analyses. Conclusions. Mothers exposed to residential traffic had no higher risk of adverse birth outcomes or pregnancy complications in this study. Future studies may be refined by taking both temporal and spatial variation in air pollution exposure into account

Chlamydia trachomatis infection during pregnancy associated with preterm delivery: a population-based prospective cohort study

Chlamydia trachomatis infection is the most prevalent bacterial sexually transmitted infection and may influence pregnancy outcome. This study was conducted to assess the effect of chlamydial infection during pregnancy on premature delivery and birthweight. Pregnant women attending a participating midwifery practice or antenatal clinic between February 2003 and January 2005 were eligible for the study. From 4,055 women self-administered questionnaires and urine samples, tested by PCR, were analysed for C. trachomatis infection. Pregnancy outcomes were obtained from midwives and hospital registries. Gestational ages and birthweights were analysed for 3,913 newborns. The C. trachomatis prevalence was 3.9%, but varied by age and socio-economic background. Chlamydial infection was, after adjustment for potential confounders, associated with preterm delivery before 32 weeks (OR 4.35 [95% CI 1.3, 15.2]) and 35 weeks gestation (OR 2.66 [95% CI 1.1, 6.5]), but not with low birthweight. Of all deliveries before 32 weeks and 35 weeks gestation 14.9% [95% CI 4.5, 39.5] and 7.4% [95% CI 2.5, 20.1] was attributable to C. trachomatis infection. Chlamydia trachomatis infection contributes significantly to early premature delivery and should be considered a public health problem, especially in young women and others at increased risk of C. trachomatis infection

Livsgnista hos mycket gamla människor : med fokus på stroke, depression och överlevnad

Background: Morale is a multidimensional concept, often defined as a future-oriented optimism or pessimism regarding the problems and opportunities associated with ageing. Very old people, older than 80 years, constitute an age group that is expected to increase in Europe from 4.7% of the general population today to 12.0% in the year 2060 in Europe. The overall aim of this thesis was to explore morale among very old people. Method: The Umeå 85+/GErontological Regional Database study (GERDA) is a population-based study carried out in parts of northern Sweden and western Finland in which every second 85 year old, every 90 year old and everyone aged 95 years and older were invited to participate. The study started the year 2000 and every five years re-invites previous participants and invites new individuals to participate in the study. The Philadelphia Geriatric Center Morale Scale (PGCMS), which is widely used to measure morale in old people, has been translated into many languages. Results: There were 598 individuals who answered the PGCMS in the Umeå 85+/GERDA study. Despite respondents’ advanced age 92.6% (554/598) answered 16 or 17 of the questions. The construct validity of the Swedish version of the PGCMS was tested among the 493 individuals who answered all 17 questions using confirmatory factor analysis and the analysis showed a generally a good fit. Reliability tested with Cronbach’s alpha was 0.74. Reliability was also tested in a convenience sample of 54 individuals (mean age of 84.7±6.7 years) and the IntraClass Correlation coefficient (ICC) was 0.89. Almost 20% (91/465) of participants who could answer the PGCMS had had a stroke. Those with stroke had significantly lower PGCMS scores than those without (10.9±3.8 vs 12.1±3.0, p-value 0.008), but there were 38.5% with stroke history who had high morale. A multiple linear regression analysis showed that depression, angina pectoris and impaired hearing were independently associated with low morale among those with a stroke history. A logistic regression model showed that each point increase in PGCMS score lowered the risk of depressive disorders five years later (odds ratio 0.779, p<0.001, with each point increase in PGCMS). In a Cox model adjusted for several demographic, health- and function-related confounders, including age and gender, mortality was higher among participants with low morale (RR=1.36, p=0.032) than those with high morale. There was a similar but non-significant pattern towards increased mortality in participants with moderate morale compared to high morale (RR=1.21, p-value=0.136). Conclusion: The feasibility and psychometric properties of the Swedish version of the PGCMS seems to be satisfactory among very old people. A large proportion of very old people have had a stroke, which is associated with reduced morale. Depression, angina pectoris and impaired hearing were independently associated with low morale among those with stroke. Among very old people, a higher level of morale seems to be associated with a lower risk of suffering from depressive disorders five years later. High morale is independently associated with increased five-year survival among very old people

Conceptual Design of Seat Belt Installation for Rear-facing Child Car Seat

Children are more vulnerable in vehicles compared to adults in collisions. Two main reasons are the different body structure between these two and vehicles are more designed to fit adults. Children’s head is larger relative to their body mass and their neck muscle ligaments are still not fully developed. Children are therefore in need of a restraint system that match their anatomy to make them protected during transportation in vehicles. Crash tests have shown that if children up to the age of five use rear-facing child car seats are the chances reduced of injuries by five times compared to front-facing. This report describes the development project of a concept which enables to fasten a rear-facing child car seat with the car seat belt. The objective was to design the fastening components for a rear-facing child car seat that suits children up to five years and considering the regulations, ECE R44, and the Swedish Plus test. This is a Master thesis that has been in collaboration with Company Xand Havd Group in Gothenburg. The project aimed to deliver a digital concept of the fastening components with information about the material, manufacturing methods, product costs, and design form. Also, was the aim to gather information through the project on what it takes to develop a rear-facing child car seat. The project consisted of five phases: planning, pre-study, ideation, detailed design and at last presentation of the result. The first phase was to plan and coordinate the project. A pre-study was then made investigating the products on the market, interviews with both users and experts regarding safety for children in vehicles, relevant literature for developing a child car seat was also collected and regulations were studied. The ideation phase developed ideas and three concepts were taken forward for development. One concept was chosen after decision making and the concept was more detailed designed in CAD.The result is presented through a CAD model which illustrates the design form and chosen material. The result is a concept that fastens the car seat belt with two hooks which can be connected to the child car seat base. In the base is two buckles designed to connect with the hooks, which uses the same fastening way used in the vehicles to fasten passengers. This is supposed to increase the usability of the installation. Material, manufacturing methods and product costs have been considered and are presented with the result

Utredning och fastställande av effektivaste metoden för spänningsreglering i mottagningsstationer

Power quality is an issue of ever increasing importance, and with ever increasingcustomer expectations on such issues, the significance of supplying customers withhigh quality power can never be underestimated. One of the most important mattersthat define power of good quality is the voltage level each customer is supplied with.Most appliances are designed to operate satisfactorily only within a narrow range ofsupply voltages. Inappropriate supply voltages can not only result in poor performingappliances, it can also cause equipment damage, increase distribution losses anddecrease the revenue for the power supplier.The point that is electrically closest to the consumers, where the voltage is activelyregulated and monitored, is usually in a zone substation, where on load tap changerson the zone substation transformers ensure that the voltage in the distribution networkis kept within appropriate limits. The supply voltage is therefore directly reliant oncorrect operation and functionality of the on load tap changers and their controllingautomatic voltage regulators. The main objective that this thesis seeks to achieve is todetermine the most effective method of voltage control to be utilised with differenttypes of zone substations, primarily with respect to the algorithms utilised in theautomatic voltage regulator.Metering data from the distribution network has been utilised to examine the presentvoltage performance of the distribution network. Different reasons that can causevoltage fluctuations and unpredictable voltage performance are investigated anddiscussed. Voltage levels that are investigated are steady-state voltages, hencetransients, flicker, and sags and swells of short duration have not been taken intoconsideration. The present voltage levels are also examined in network models, withthe aim to investigate the impact of altered methods of voltage control in zonesubstations. The accuracy of the utilised network models is also investigated, bycomparing metering data to modelled voltage levels.This thesis is undertaken with the assistance of Ergon Energy Corporation Limited, acorporation owned and operated by the Queensland Government. Ergon Energy ownsand operates the subtransmission and distribution network in regional Queensland. Itis intended that this thesis will aid understanding of the voltage performance of thedistribution network, and that it will bring clarity to how the voltage in thedistribution network should be controlled in order to achieve optimum voltageperformance.Uppsatsnivå:

Conceptual Design of Seat Belt Installation for Rear-facing Child Car Seat

Children are more vulnerable in vehicles compared to adults in collisions. Two main reasons are the different body structure between these two and vehicles are more designed to fit adults. Children’s head is larger relative to their body mass and their neck muscle ligaments are still not fully developed. Children are therefore in need of a restraint system that match their anatomy to make them protected during transportation in vehicles. Crash tests have shown that if children up to the age of five use rear-facing child car seats are the chances reduced of injuries by five times compared to front-facing. This report describes the development project of a concept which enables to fasten a rear-facing child car seat with the car seat belt. The objective was to design the fastening components for a rear-facing child car seat that suits children up to five years and considering the regulations, ECE R44, and the Swedish Plus test. This is a Master thesis that has been in collaboration with Company Xand Havd Group in Gothenburg. The project aimed to deliver a digital concept of the fastening components with information about the material, manufacturing methods, product costs, and design form. Also, was the aim to gather information through the project on what it takes to develop a rear-facing child car seat. The project consisted of five phases: planning, pre-study, ideation, detailed design and at last presentation of the result. The first phase was to plan and coordinate the project. A pre-study was then made investigating the products on the market, interviews with both users and experts regarding safety for children in vehicles, relevant literature for developing a child car seat was also collected and regulations were studied. The ideation phase developed ideas and three concepts were taken forward for development. One concept was chosen after decision making and the concept was more detailed designed in CAD.The result is presented through a CAD model which illustrates the design form and chosen material. The result is a concept that fastens the car seat belt with two hooks which can be connected to the child car seat base. In the base is two buckles designed to connect with the hooks, which uses the same fastening way used in the vehicles to fasten passengers. This is supposed to increase the usability of the installation. Material, manufacturing methods and product costs have been considered and are presented with the result

Livsgnista hos mycket gamla människor : med fokus på stroke, depression och överlevnad

Background: Morale is a multidimensional concept, often defined as a future-oriented optimism or pessimism regarding the problems and opportunities associated with ageing. Very old people, older than 80 years, constitute an age group that is expected to increase in Europe from 4.7% of the general population today to 12.0% in the year 2060 in Europe. The overall aim of this thesis was to explore morale among very old people. Method: The Umeå 85+/GErontological Regional Database study (GERDA) is a population-based study carried out in parts of northern Sweden and western Finland in which every second 85 year old, every 90 year old and everyone aged 95 years and older were invited to participate. The study started the year 2000 and every five years re-invites previous participants and invites new individuals to participate in the study. The Philadelphia Geriatric Center Morale Scale (PGCMS), which is widely used to measure morale in old people, has been translated into many languages. Results: There were 598 individuals who answered the PGCMS in the Umeå 85+/GERDA study. Despite respondents’ advanced age 92.6% (554/598) answered 16 or 17 of the questions. The construct validity of the Swedish version of the PGCMS was tested among the 493 individuals who answered all 17 questions using confirmatory factor analysis and the analysis showed a generally a good fit. Reliability tested with Cronbach’s alpha was 0.74. Reliability was also tested in a convenience sample of 54 individuals (mean age of 84.7±6.7 years) and the IntraClass Correlation coefficient (ICC) was 0.89. Almost 20% (91/465) of participants who could answer the PGCMS had had a stroke. Those with stroke had significantly lower PGCMS scores than those without (10.9±3.8 vs 12.1±3.0, p-value 0.008), but there were 38.5% with stroke history who had high morale. A multiple linear regression analysis showed that depression, angina pectoris and impaired hearing were independently associated with low morale among those with a stroke history. A logistic regression model showed that each point increase in PGCMS score lowered the risk of depressive disorders five years later (odds ratio 0.779, p<0.001, with each point increase in PGCMS). In a Cox model adjusted for several demographic, health- and function-related confounders, including age and gender, mortality was higher among participants with low morale (RR=1.36, p=0.032) than those with high morale. There was a similar but non-significant pattern towards increased mortality in participants with moderate morale compared to high morale (RR=1.21, p-value=0.136). Conclusion: The feasibility and psychometric properties of the Swedish version of the PGCMS seems to be satisfactory among very old people. A large proportion of very old people have had a stroke, which is associated with reduced morale. Depression, angina pectoris and impaired hearing were independently associated with low morale among those with stroke. Among very old people, a higher level of morale seems to be associated with a lower risk of suffering from depressive disorders five years later. High morale is independently associated with increased five-year survival among very old people